Healthcare Provider Details

I. General information

NPI: 1730811472
Provider Name (Legal Business Name): KIMBERLY CHRISTY BECK NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HEALTH PARK DR
LOUISVILLE CO
80027-9583
US

IV. Provider business mailing address

6343 TRAPPERS TRAIL AVE
PARKER CO
80134-2762
US

V. Phone/Fax

Practice location:
  • Phone: 303-673-1000
  • Fax:
Mailing address:
  • Phone: 714-403-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number104369387
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: